NPIMap

Organization Active NPI

County of Ottawa

Doing business as Ottawa County Health Department

  • Primary Care Clinic/Center
  • Port Clinton, OH
National Provider Identifier
1669514303
Registry record updated Apr 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
COUNTY OF OTTAWA
Doing business as
Ottawa County Health Department
Practice address
1856 E Perry St
Port Clinton, OH 43452-1497
Phone
(419) 734-6800
Fax
(419) 734-6888
NPI assigned
Feb 12, 2007
Last updated
Apr 26, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Nancy C Osborn, RN, MPA
Title
Health Commissioner
Phone
(419) 734-6800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

1856 E Perry St
Port Clinton, OH 43452-1497

Mailing address

1856 E Perry St
Port Clinton, OH 43452-1497
Phone (419) 734-6800

Other identifiers 2

IdentifierTypeStateIssuer
0273556MedicaidOH
P00082792OtherOHMEDICARE RAILROAD

Other names 1

  • Ottawa County Health Department Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120425000782 OH Part B Supplier - Mass Immunization (Roster Biller Only) 9032379029 Practice locations: Port Clinton, OH

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

  • County of Ottawa

    dba Ottawa County Riverview Nursing Home

    • Skilled Nursing Facility
    • Oak Harbor, OH
    • NPI 1346232741

    9032379029

    Same PAC ID

National Provider Directory

National Provider Directory
Tax ID family
County of Ottawa6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1856 E Perry St
Port Clinton, OH 43452
Phone (419) 734-6800

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ecs SolutionsOak Harbor, OH, CCN 365498 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF
Direct Ownership Interest (100%)		 Jun 1, 1980
Jun 1, 1980
Jun 1, 1980
Jun 1, 1980

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • County of Ottawa

    dba Ottawa County Riverview Nursing Home

    • Skilled Nursing Facility
    • Oak Harbor, OH
    • NPI 1346232741

    5% Or Greater Direct Ownership Interest, Adp of the SNF, Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335398400000",
    "number": "1669514303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1856 E PERRY ST",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "434521497",
            "telephone_number": "419-734-6800",
            "fax_number": "419-734-6888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1856 E PERRY ST",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "434521497",
            "telephone_number": "419-734-6800",
            "fax_number": "419-734-6888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF OTTAWA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2012-04-26",
        "status": "A",
        "authorized_official_last_name": "OSBORN",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "HEALTH COMMISSIONER",
        "authorized_official_telephone_number": "419-734-6800",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN, MPA"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0273556",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00082792",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ottawa County Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Clinton, OH

Sources for this page

Verify at the official NPI Registry.